What is Ascites?

Ascites refers to the accumulation of serous pale yellow and clear fluid in the peritoneal or abdominal cavity, located below the chest cavity and separated from it by a diaphragm.

The fluid could be a result of many complications including liver diseases, kidney failure, cancers and congestive heart failure. The basic principle is similar to formation of edema, owing to imbalance of pressure between the external and internal systems.


If the quantity of fluid is less than 100 to 400ml, mild ascites might have no symptoms at all. With the increase in the quantity of fluid, the following symptoms may be observed:

  • Increased abdominal girth
  • Increased abdominal size
  • Bloating
  • Shortness of breath
  • Abdominal pain
  • Abdominal discomfort
  • Disfiguring large belly


The exact mechanism of the development of ascites is not yet fully understood. However, the main causes are:

  • Portal hypertension – Increased blood pressure in liver
  • Increase in portal blood pressure
  • Decrease in albumin content of the blood
  • Salt retention in blood
  • Water retention in blood
  • Congestive heart failure
  • Advanced kidney failure
  • Tumors in abdominal cavity
  • Blood clots in portal vessel
  • Cancers like malignant ascites, colon cancer, pancreatic cancer, stomach cancer, breast cancer, lymphoma, lung cancer or ovarian cancer.
  • Chronic inflammation of pancreas
  • Alcohol abuse
  • Trauma to pancreas


The risk factors of Ascites are:

  • Diets with low protein content
  • Excessive consumption of alcohol
  • Hepatitis
  • Cardiac diseases
  • Cirrhosis
  • Chronic liver diseases
  • Portal hypertension


Ascites can be prevented with the following precautionary methods:

  • Reduced consumption of alcohol and tobacco
  • Maintaining a healthy body weight
  • Limiting the intake of salt in the diet
  • Practicing safe sex to avoid hepatitis
  • Avoiding recreational drugs that could cause hepatitis

How is it diagnosed?

At Medanta, our experts use several means of diagnosing Ascites, including - 


How is it treated?

Like all other diseases, the treatment for ascites depends largely on the cause. Therefore, the treatment procedures adopted by your doctor at Medanta for ascites are:


  • Diet

    You would be advised to:

    • Decrease Sodium intake to less than 2 grams per day
    • Take diuretics or water pills along with less salt diet, for greater effect

  • Pharmacotherapy

    Diuretics are recommended to increase water and salt excretion from the kidneys.

  • Therapeutic paracentesis

    Excessive fluid can be removed by extracting it from the abdominal area, using a needle and in sterile conditions. About four to five litres of fluid can be drained in this method, every time.

  • Surgical procedures

    If your case is refractory and does not seem to respond well to the methods described above, your doctor may suggest a surgical therapy to treat ascites. 

  • Transjugular intrahepatic portosystemic shunts

     This is a procedure done through the internal jugular vein (the main vein in the neck) under local anaesthesia by an interventional radiologist. A shunt is placed between the portal venous system and the systemic venous system (veins returning blood back to the heart), thereby reducing the portal pressure. This procedure is reserved for patients who have minimal response to aggressive medical treatment. It has been shown to reduce ascites and either limit or eliminate the use of diuretics in a majority of cases performed. However, it is associated with significant complications such as hepatic encephalopathy and even death. More traditional shunt placements like peritoneovenous shunt and systemic portosystemic shunt have been essentially abandoned due to their high rate of complications.}|

  • Liver transplant

    Liver transplantation for advanced cirrhosis may be considered a treatment for ascites due to liver failure. Liver transplant involves a very complicated and prolonged process and it requires very close monitoring and management by transplant specialists.

When do I contact the doctor?

Contact your doctor at Medanta if you observe the symptoms such as abdominal swelling, weight gain, bloating, sense of fullness, nausea, vomiting, shortness of breath, or swelling in lower legs.

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